IRISi is a social enterprise that promotes the IRIS programme, a specialist domestic violence and abuse (DVA) training, support, and referral programme for general practices. The initiative main’s goal is to improve the healthcare response to gender-based violence through health and specialist services working together.
That said, we answered 5 of the most frequently asked questions regarding DVA and healthcare.
#01 How frequently DVA goes unrecognised?
In a nationally representative primary care database of approximately 6% of the UK population, only 0.5% of women had DVA recorded, compared to the Office for National Statistics estimated prevalence of 17%. While it is impossible to know exactly how much DVA is under-recorded, it is clear that multiple strategies are needed to improve identification for those affected by DVA.
#02 Why DVA is a gender-based issue?
In the United Kingdom, in the year ending March 2017, 7.5% of women (1.2 million) experienced domestic abuse. The number is now closer to 2 million. While DVA can affect both men and women, it is a gendered issue. Women are more often exposed to multiple forms of abuse and more frequently so. Women who experience DVA suffer chronic health problems including gynecological problems, gastrointestinal disorders, neurological symptoms, chronic pain, cardiovascular conditions, and mental health problems.
According to Canadian General Social Survey (2006), compared with male DVA survivors, women are:
- 3x more likely to be injured as a result of violence;
- 5x more likely to require medical attention or hospitalisation;
- 5x more likely to report fearing for their lives;
- 8x more likely to suffer sexual violence.
#03 Why General Practice should improve their response to DVA?
A few years ago, Health Foundation published “Improvement in Practice: The IRIS Case Study“, a report focused in explain and explore exactly how IRIS intervention works and why it is so urgent for primary healthcare to embrace the programme.
The article highlights that between 6 and 23% of women attending general practice will have experienced physical or sexual abuse from their partner. “Domestic Violence is a common problem that is almost invisible in primary healthcare, even though women would most like to receive support from their doctors. Only around 15% of women with a history of domestic violence have any reference to violence in their medical records in primary care. When a woman does disclose domestic violence, the response is frequently unsatisfactory as doctors and nurses are often unaware of appropriate interventions”.
#04 How much DVA costs?
A recent study by the Home Office estimated that cost of domestic abuse for its victims in the year ending on 31st March 2017 was approximately £66 billion. That is at least 6 times more than previously estimated. In 2012, the cost of DVA in the UK, including medical and social services, lost economic output and emotional costs, was estimated to be £11 billion.
#05 How the IRIS programme can support your practice and patients to identify DVA?
Each practice that becomes part of the IRIS programme receives a named Advocate Educator.
Our Advocate Educator (AE) provides support to both the practice and the patients that are recognised and referred.
Support for your practice:
👉In-house specialist domestic violence training sessions to become better equipped to respond to concerns and disclosures of DVA from all patients including perpetrators. This includes training for all your clinicians, as well as your reception/administrative team.
👉Ongoing support and DVA consultancy after training is completed from a named Advocate Educator.
👉Literature (posters and cards) for your practice explaining that you are a DVA aware practice.
👉Developed and enhanced safeguarding responses to both children and adults.
👉A simple referral pathway for your patients to a named Advocate Educator, reducing the time required from GPs and practices to respond to disclosures and related issues.
👉A certificate for each clinician who attends training, counting towards their CPD points.
👉Regular attendance from your Advocate Educator at practice meetings to remind staff about the service and provide support with challenging cases.
Support for your patients:
👉Emotional support, a safe place to talk about how DVA has affected them and the impact this can have on their emotional/physical well-being. The Advocate Educator works in a patient-centred way, at the patients pace, outlining options and choices.
👉Practical support, including advice around finances/benefits, referrals into counseling/group work, housing, legal advice, safety planning, referrals to MARAC/safeguarding, support reporting to Police or attending court.
If you are a commissioner, our programme can help improve both clinical practice and quality of life for patients in your area. If you are a clinician, the IRIS programme is here to train you to identify Domestic Violence and Abuse in its early stages and to support your patients. Let us help you so you can help them.